Chronic pain is a significant public health problem, associated with impairments of physical and psychological functioning. While a third or more of the general population may suffer from chronic pain, it is often under recognized and under treated in health care settings. Low income and minority samples experience disparities in the prevalence of chronic pain, in perceived access to effective pain treatment, and in consultations for pain. A great deal of literature suggests that acupuncture offers potential benefit in the management of chronic pain, but it is rarely available to low income patients. The Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) project will introduce and evaluate the addition of acupuncture to the management of chronic pain for ethnically diverse, low-income primary care patients. The project represents a collaboration between the New York City Research and Improvement Networking Group (NYC RING), a practice-based research network dedicated to decreasing health disparities through primary care research, the Continuum Center for Health and Healing, and The Swedish Institute School of Acupuncture. Our intervention will involve addition of weekly acupuncture sessions at 3 urban primary care practices. During training sessions at each practice, primary care providers will become familiar with acupuncture and indications for referral. Patients will be eligible if they experience chronic pain due to neck pain, back pain, or osteoarthritis. Our process evaluation, guided by Glasgow's RE- AIM framework, will assess barriers to implementation and adoption of the intervention in busy urban practices and acceptability to patients and providers. We will employ a quasi- experimental design to assess primary outcomes (pain and quality of life) and obtain preliminary estimates of secondary outcomes (health care utilization and costs) of the intervention at each health center. This design will permit comparison across sites to discern practice level differences in uptake and outcomes. PUBLIC HEALTH REVELANCE: Chronic pain is often under recognized and under treated, especially in vulnerable populations. Acupuncture offers a potentially effective addition to pain management often not available to low-income patients. Our project will introduce acupuncture into chronic pain treatment in urban safety net primary care sites and evaluate the acceptability to patients, the effectiveness of acupuncture in reducing pain and improving quality of life, and obtain preliminary estimates of the effect on health care utilization, medication use, and cost.